title: Is structured group psychoeducation for bipolar patients effective in ordinary mental health services? A controlled trial in Italy.
abstract: BACKGROUND
  Recent reviews of evidence-based guidelines for the clinical management of Bipolar Disorders (BD) have recommended that "all patients with BD be offered group or individual psychoeducation" to prevent relapse, improve treatment adherence, quality of life, and functioning. The present study evaluated the effectiveness of psychoeducation in routine mental health services in reducing number of hospitalisations and number of days spent in hospital, at a 1-year follow-up.
  
  
  METHODS
  A total of 102 outpatients were recruited from two Italian Departments of Mental Health. Inclusion criteria were a lifetime BD type I or II diagnosis, assessed with SCID, and ≥ 3 months of euthymia. Exclusion criteria were DSM-IV Axis I comorbidity, mental retardation (IQ<70), organic brain damage, or deafness. All participants received standard psychiatric care, including standard pharmacological treatment; the experimental group also received 21 group psychoeducation sessions, weekly held and conducted according to Colom and Vieta's model.
  
  
  RESULTS
  The number of patients hospitalised during the 1-year follow-up, the mean number of hospitalisations per patient, and the mean number of hospitalisation days were significantly lower for psychoeducated patients.
  
  
  CONCLUSIONS
  Our findings support the view that group psychoeducation is an effective way to prevent hospitalisation and decrease hospital days in pharmacologically treated patients with bipolar disorder also in routine clinical settings. The results confirm that psychoeducation promotes improvement in illness course by preventing acute phases and enhancing mood stability, and consequently, improvement in the quality of life for people with BD.
authors.affiliation: IRCCS "St. John of God" Fatebenefratelli-Brescia, Via Pilastroni 4, Brescia 25125, Italy. vcandini@fatebenefratelli.it
authors.forename: Valentina
authors.initials: V
authors.lastname: Candini
authors.forename: Chiara
authors.initials: C
authors.lastname: Buizza
authors.forename: Clarissa
authors.initials: C
authors.lastname: Ferrari
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Caldera
authors.forename: Roberta
authors.initials: R
authors.lastname: Ermentini
authors.forename: Alberto
authors.initials: A
authors.lastname: Ghilardi
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Nobili
authors.forename: Rosaria
authors.initials: R
authors.lastname: Pioli
authors.forename: Margherita
authors.initials: M
authors.lastname: Sabaudo
authors.forename: Emilio
authors.initials: E
authors.lastname: Sacchetti
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Saviotti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Seggioli
authors.forename: Amneris
authors.initials: A
authors.lastname: Zanini
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bipolar disorder; Hospitalization; Integrated treatment; Psychoeducation; Rehabilitation; Relapse prevention